As mental health and palliative care researchers struggle to understand how individuals cope with and react to the dying process, the importance of hopelessness has gradually emerged as a critical construct. A growing literature, including several studies by our research group, has identified hopelessness as a principle explanatory variable in end-of-life despair, including the desire for hastened death, interest in physician assisted suicide, and suicidal ideation. Yet understanding what it means to be "hopeless" in the context of a terminal illness has received little attention to date. Confusion abounds as to whether hopelessness in the face of terminal illness simply refers to a realistic appraisal of one's prognosis (i.e., the absence of any hope for a cure), the patient's expectations for the immediate future (e.g., the absence of meaning and value in the last weeks or months of life), or reflects a general pessimistic cognitive style that may even pre-date the diagnosis or terminal phase of illness. Given the growing realization of the central role that hopelessness plays in psychological adjustment to terminal illness, the need to better understand and measure the construct of hopelessness among terminally ill individuals is clear. In this project we seek to fill this void by first exploring the construct of hopelessness in the context of life threatening/terminal illness and to subsequently develop a tool to facilitate the measurement of this construct. To accomplish these aims we will utilize a series of steps, beginning with individual interviews with palliative care experts and terminally ill cancer patients, followed by the development and refinement of a brief self-report measure that will be validated in a large sample of terminally ill and ethnically diverse cancer patients. The development of such a measure will help foster more sophisticated studies examining the role of hopelessness in end-of-life care as well as help facilitate the development of clinical interventions aimed at reducing end-of-life despair.